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Why taking a sick day depends on more than being sick

The study revealed a clear divide: workers in casual and fixed term jobs take only around one day of sick leave a year on average, compared with about four days for permanent employees.

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As winter illness spreads and households face cost-of-living pressure, many Australians cannot treat a sick day as a simple health decision. They may be too sick to work – but their job is too insecure to stay home.

New research led by the University of Technology Sydney (UTS) shows the decision is heavily influenced by pay, job security and gender. The study, published in Applied Economics, examines how workers’ health and economic circumstances dictate how many sick days they actually take.

“Employers and policymakers often focus on reducing absence, but workers who attend while unwell may recover more slowly, spread infection to colleagues, and be less productive,” said lead researcher Dr Nancy Kong, a Senior Research Fellow at the UTS Centre for Health Economics Research & Evaluation.

Drawing on data from the Household, Income and Labour Dynamics in Australia (HILDA) survey from more than 15,000 Australians between 2005 and 2016, Dr Kong and her co-authors, Dr David Rowell from the University of Queensland and Professor Peter Zweifel from the University of Zurich, examined patterns of sick leave across the workforce. 

“We focused on this period to avoid the COVID years, when major changes in public health rules, workplace practices and leave policies occurred at the same time, and could have blurred the relationship between job conditions and sick leave,” said Dr Kong.

The study revealed a clear divide: workers in casual and fixed term jobs take only around one day of sick leave a year on average, compared with about four days for permanent employees.

Even accounting for variables such as occupation, job satisfaction, household circumstances, living arrangements, marital status, education and place of residence, non-permanent workers still take around three fewer sick days each year.

“This does not necessarily mean casual and fixed-term workers are healthier,” said Dr Kong.

“A more likely explanation is that taking time off is riskier when work is insecure. Non-permanent workers may have less access to paid sick leave. They may also worry that saying no to work, even when ill, could affect future hours or their chances of keeping their job.”

“For a permanent employee, staying home with influenza might be inconvenient; but for a casual worker it may trigger financial stress.”

The study also found that economic insecurity plays a role, with workers living in areas with higher unemployment tending to take less sick leave.

For instance, when the local unemployment rate rises by five percentage points, sick leave drops. While this amounts to a fraction of a day per individual, across a standard team this adds up to significant forgone recovery time.  

This pattern is consistent with a simple concern: when jobs feel harder to replace, workers may be less willing to take time off.

“They may worry that being absent could make them seem less reliable or increase the risk of losing work,” said Dr Kong.

The effect of wages proved more nuanced. Higher wages alone did not consistently dictate leave behaviour. However, among workers in poorer health, higher wages were strongly associated with taking more sick leave, suggesting higher income earners possess a financial buffer.

“Higher-paid workers generally have workplace support and leave entitlements that mean they are supported to take time off when they are unwell without fear of a potential financial penalty,” said Dr Kong.

The most consistent finding was a distinct gender gap.  Across every analysis, men take fewer sick days than women, averaging about half a day less per year (a 23% difference), even when matching with similar health and job circumstances.

“This may reflect differences in health needs, caring responsibilities or how likely people are to seek medical care,” Dr Kong said. 

“But it also points to workplace cultures and gender expectations about ‘toughness’, reliability and working through illness.”

Ultimately, the study highlights that sick leave rates are not simply a reflection of physical health. For employers, low sick leave rates should not be automatically viewed as a sign of success; they may also indicate a culture of fear.

“Workplace cultures should not reward people for attending when unwell or treat legitimate sick leave as a lack of commitment,” said Dr Kong.

“Reducing stigma is also particularly important in addressing the gender gap.”

Dr Kong said for policymakers, the study points to the importance of secure work, accessible paid leave and workplace practices that support people to recover when unwell.

This is particularly relevant during periods of increased cost-of-living pressure, workforce shortages and seasonal illness.

“A fair and effective sick leave system should support productivity while ensuring workers do not have to choose between protecting their health and protecting their income.”

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Why a UTI hurts — and why that might be a good thing

Australian researchers have discovered a previously overlooked group of bladder nerves that help detect urinary tract infections (UTIs) and trigger the body’s response to clear them, providing a potential new target for future bladder pain therapies.

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Australian researchers have discovered a previously overlooked group of bladder nerves that help detect urinary tract infections (UTIs) and trigger the body’s response to clear them, providing a potential new target for future bladder pain therapies.

The study shows that bladder nerves located close to the lining of the bladder act as a frontline infection sensor, helping the body recognise UTIs and trigger responses that reduce the severity and spread of infection.

UTIs are among the most common bacterial infections worldwide, with more than 400 million cases reported every year. Nearly one in three women will experience UTIs before the age of 24, and many elderly people and those with bladder issues from spinal cord injuries can experience multiple UTIs in a single year.

Symptoms often include frequent urination, a sudden urge to urinate, pain during urination, and pelvic discomfort can be debilitating for some patients.

Flinders University’s Dr Luke Grundy says that while scientists have long understood how the bladder senses as it fills and triggers urination, the role of a specialised group of bladder nerves near the bladder lining has remained unclear.

“Most bladder nerves act like a fuel gauge, telling the brain when the bladder is filling up and needs emptying,” says Dr Grundy, Head of the NeuroUrology Research Group at Flinders University.

“The nerves we studied in this research are different. They sit close to the bladder lining and appear to act more like an early warning system, detecting infection and inflammation.

“They don’t just sense infection. They help coordinate the body’s response to it by triggering pain and urinary frequency, behaviours that appear to help clear bacteria from the bladder as part of the body’s defence system.”

Lead author and recently graduated PhD student Dr Cindy Tay says the discovery changes how these nerves are understood.

“These mucosal nerves have puzzled scientists for almost two decades because they stay quiet while the bladder fills and empties, which is the main job of the bladder,” says Dr Tay.

“What we’ve found is that they have a hidden job — acting as an early warning system that springs into action the moment infection takes hold.”

The research team developed a novel method to selectively study a specialised group of sensory nerves in the bladder lining of mice, revealing that while these nerves play little role in normal bladder function, they become highly responsive during a UTI and help detect and respond to infection.

“When the bladder is healthy, these nerves are relatively quiet, but during a urinary tract infection they become highly sensitive and respond to the presence of bacteria and inflammation,” says Dr Grundy.

“It may feel unpleasant, but urinating more frequently actually helps clear the infection by flushing out the harmful bacteria.”

The study also helps explain why people with conditions affecting nerve function may be more prone to recurrent or severe UTIs.

“If the nerves that detect infection aren’t working properly, the body may not respond as effectively,” says Dr Grundy.

Building on previous research, the new study reveals a deeper understanding of how UTIs affect bladder function and the nervous system, and could help develop new treatments that target these nerves to relieve UTI-related symptoms.

“Our findings provide new insight into how the bladder detects and responds to infection, helping explain the biological processes that drive the pain, urgency and discomfort commonly experienced during UTIs,” says Dr Grundy

Researchers say the next challenge is to develop therapies that ease the pain and urgency associated with UTIs while preserving the protective role these nerves play in fighting infection.

The paper, ‘Bladder mucosal afferents detect UTI and aid pathogen clearance,’ by Cindy Tay, Harman Sharma, Stewart Ramsay (University of Adelaide), Georgia Bourlotos, Sarah K Manning, Natalie E Stevens, Sophie J Miller, Geraint B Rogers, David J Lynn, Feargal J Ryan, Andrea M Harrington (University of Adelaide), Vladimir Zagorodnyuk, Steven L Taylor and Luke Grundy was published in Proceedings of the National Academy of Sciences (PNAS).

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Pregnancy complications can signal heart disease risk years before traditional screening, study finds

Some women, particularly younger women often considered low risk, may face a higher risk of heart disease earlier than previously recognized.

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McGill University researchers have developed a new tool to identify heart disease risk in women earlier in life.

Findings from a study published in JACC: Advances highlight gaps in existing approaches.

“Heart disease is the leading cause of death in women, yet existing risk tools were developed in older populations and ignore factors unique to women,” said senior author Robert Platt, Professor in the Department of Epidemiology, Biostatistics, and Occupational Health and Director of the School of Population and Global Health.

While pregnancy complications are known to be linked to future heart risk, there has been no way to identify which younger women are most at risk, he added.

Detecting risk earlier

Using health data from more than 260,000 women in the UK aged 15 to 45 who had given birth, researchers developed and validated a prediction model to estimate future heart disease risk. Participants were followed for nearly four years after delivery.

The model identified several factors – not included in existing tools – that can help predict risk, including hypertensive disorders of pregnancy, gestational diabetes, preterm birth, PCOS, depression, thyroid disorders, oral contraceptive use and social deprivation.

The findings suggest some women, particularly younger women often considered low risk, may face a higher risk of heart disease earlier than previously recognized.

“Millions of women who give birth each year are never considered candidates for cardiovascular risk assessment simply because of their age,” said co-author Kristian Filion, Professor in the Departments of Medicine and of Epidemiology, Biostatistics, and Occupational Health.

If integrated into routine postpartum care, this tool could enable earlier monitoring, lifestyle counselling or referral to a specialist, potentially helping prevent a heart attack or stroke later in life, he added.

The next step is to validate the model in Canada and the United States. In the longer term, the goal is to integrate a practical calculator into electronic health records so higher-risk patients can be identified earlier.

About the study

Development and Validation of a Prediction Model for Cardiovascular Risk in Reproductive-Aged Women” by Sonia Grandi, Kristian Filion, Jennifer Hutcheon, Graeme Smith, and Robert Platt was published in JACC: Advances. The study was supported by the Canadian Institutes of Health Research.

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Posture can influence your mood and behavior, study suggests

The findings do not mean that changing posture can dramatically transform a person’s life, but it does raise interesting questions about whether everyday features of our environment – such as workplace ergonomics – can subtly influence mood and behavior.

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A person’s posture appears to affect their emotions and decision-making ability more than they realize, according to new research from McGill University. In a recent study, participants sitting upright performed better at a risk-taking task and reported more positive feelings than did their peers in the slouching or control groups.

Though the effects were modest and observed in a laboratory setting, the results highlight the body’s influence on our mood and behavior, said Jorge Armony, professor in the Departments of Psychiatry and Psychology at McGill and senior author of the study.

A cover story to influence body position

Armony and graduate student Soren Wainio-Theberge, who originated the idea for the research and is a co-author of the paper, recruited nearly 200 participants from the McGill community.

After some initial testing on a computer monitor, they asked them to complete a new task on a tablet, under the guise of testing a mobile application. For some, the tablet was positioned on a stand on an adjustable table, to encourage an upright posture while sitting. For others, it was placed flat on the desk, which was also positioned at a lower setting, prompting participants to hunch over.

Participants then completed a risk-taking test, in which players can earn rewards by inflating a virtual balloon, but risk losing everything if it bursts. Over the course of the task, participants in the upright posture took greater risks and tended to earn greater rewards.

“This suggests they were not acting more impulsively but rather were engaging in more effective risk-taking,” explained Armony.

In the accompanying questionnaire, participants in the upright group also reported significantly higher feelings of pride, which is associated with a positive mood.

Bringing new insight to posture research

The findings shed light on the long-debated notion that the body’s posture can influence the mind.

The McGill team tested this relationship while avoiding concerns associated with previous studies.

The researchers avoided telling subjects which posture to adopt, but, rather, influenced their choice without their knowledge. This helped address a common criticism of earlier “power pose” research: that results may simply reflect that participants responded to researchers’ expectations. In post-experiment interviews, most participants indicated that they were unaware their posture had been manipulated.

The researchers also used video software to measure neck angle as a benchmark for posture conformity. In previous studies, this had not often been measured.

The findings do not mean that changing posture can dramatically transform a person’s life, Armony cautioned, but it does raise interesting questions about whether everyday features of our environment – such as workplace ergonomics – can subtly influence mood and behavior.

About the study

Manipulating posture implicitly through environmental constraints influences mood and
risk-taking behaviour
”, by Soren Wainio-Theberge and Jorge Armony, was published in the British Journal of Psychology.

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